吴茭山治一妇人。久患白带。瘦削无力。倦怠欲睡。腰酸腿痛。饮食无味。面黄。日晡
烦热。小便淋沥。以归身、茯苓各一钱。炒芍药、地骨皮、白术、川芎、人参各八分。黄芩
鹿角胶各一钱。炙草、熟地、车前子各五分。枣二枚。水煎服。数服而愈。后治数妇皆验
程明佑治一妇。病带下不止。医投调经剂。血愈下。复投寒凉药。遂下泄。肌肉如削。
不能言。四肢厥逆。程诊其脉细如丝。曰。阳气微而不能营阴。法当温补。阳生则阴长而血
不
下漏。遂以人参二两。附子三片。浓煎。一服手足微温。再服思食。继服八珍四十剂愈。
立斋治一妇人。头晕吐痰。胸满气喘。得食稍缓。苦于白带。二十余年矣。诸药不应。
薛曰。此气虚而有痰饮也。饮愈带始愈。遂用六味地黄丸。不月而验。
震按六味地黄。岂能治饮。就此证宜六君与肾气丸并用。即如首案。熟地仅用五分。次
案附子仅用三片。俱不可解。
一妇人吞酸胸满。食少便泄。月经不调。服清气化痰丸。两膝渐肿。寒热往来。带下黄
白。面黄体倦。此脾胃虚湿热下注。用补中益气倍参、术。加茯苓、半夏、炮姜而愈。若因
怒。发热少食。或两腿赤肿。或指缝常湿。用六君加柴胡、升麻。及补中益气。
孙东宿治吴太夫人。年六十余。久患白带。历治不效。变为白崩。诊得右寸滑。左寸短
弱。两关濡。两尺皆软弱。孙曰。据脉心肾俱不足。而中焦有湿。今白物下多。气血日败。
法当燥脾。兼补心肾。乃制既济丹。用鹿角霜、当归、茯苓各二两。石菖蒲、远志各一两五
钱。龙骨、白石脂各一两。益智仁五钱。山药糊丸。空心服以补心肾。又制断下丸。用头二
蚕沙炒三两。黄荆子炒二两。海螵蛸磨去黑甲、樗根白皮各一两。面糊丸。午后服以燥中宫
之湿。不终剂而愈。
震按今之妇人。患带下者十居八九。而带下之虚证。亦十居八九。虚证挟肝火。挟湿热
者。又十居八九。若不虚而只是肝火与湿热者。仅十之一二而已。故此门集案虽少。其治法
大旨。已约略可见。
吴茭山治疗一位妇人。长期患有白带，身体消瘦无力，倦怠嗜睡，腰酸腿痛，饮食无味，面色萎黄，午后烦热，小便淋漓不畅。处方用当归身、茯苓各一钱，炒白芍、地骨皮、白术、川芎、人参各八分，黄芩、鹿角胶各一钱，炙甘草、熟地黄、车前子各五分，大枣两枚，水煎服。服用数剂后痊愈。后来治疗几位妇女都验证有效。
程明佑治疗一位妇人，病证为带下不止。医生投用调经药剂，导致出血更多；又投用寒凉药物，于是出现泄泻，肌肉极度消瘦，不能说话，四肢厥冷。程明佑诊察其脉象细如丝线，说：“阳气微弱而不能滋养阴血，治法应当温补。阳气生发则阴血生长，血就不致下漏。”于是用人参二两、附子三片，浓煎，服用一次后手足微微变暖，再服后思食，继服八珍汤四十剂而愈。
立斋（薛己）治疗一位妇人，头晕吐痰，胸满气喘，进食后稍缓解，苦于白带，已有二十多年了。各种药物均无效。薛己说：“这是气虚而有痰饮。痰饮消除，白带才会痊愈。”于是使用六味地黄丸，不到一个月见效。
俞震按语：六味地黄丸怎么能治疗痰饮？就这个证候而言，适宜将六君子汤与肾气丸并用。就像第一个医案，熟地黄仅用五分；第二个医案附子仅用三片，都不易理解。
一位妇人吞酸胸满，食少便泄，月经不调，服用清气化痰丸后，双膝逐渐肿胀，寒热往来，带下黄白相间，面色萎黄，身体疲倦。这是脾胃虚弱，湿热下注。用补中益气汤，加倍人参、白术，加茯苓、半夏、炮姜而愈。如果因愤怒引起发热、食少，或双腿红肿，或指缝常湿，用六君子汤加柴胡、升麻，以及补中益气汤。
孙东宿治疗吴太夫人，六十多岁，长期患白带，经过多种治疗无效，变为白崩（大量白色分泌物下泄）。诊得右寸脉滑，左寸脉短弱，两关脉濡，两尺脉皆软弱。孙东宿说：“根据脉象，心肾俱不足，而中焦有湿。现在白色分泌物下泄过多，气血日渐败坏，治法应当燥脾，兼补心肾。”于是配制既济丹，用鹿角霜、当归、茯苓各二两，石菖蒲、远志各一两五钱，龙骨、白石脂各一两，益智仁五钱，山药糊为丸，空腹服用以补心肾。又配制断下丸，用头蚕沙炒制三两，黄荆子炒制二两，海螵蛸磨去黑甲、樗根白皮各一两，面糊为丸，午后服用以燥中宫之湿。未服完一剂而痊愈。
俞震按语：现在的妇人，患带下病的十有八九，而带下的虚证，也十有八九。虚证夹杂肝火、夹湿热的，又十有八九。如果不虚，仅仅是肝火与湿热的，仅占十分之一二而已。所以这一门类收集的案例虽然少，但治疗的总体原则，已大致可见。
Wu Jiaoshan treated a woman who had suffered from leukorrhea (vaginal discharge) for a long time. She was emaciated and weak, fatigued and sleepy, with soreness and pain in the lower back and legs, loss of appetite, sallow complexion, afternoon vexation and heat, and dribbling urination. The prescription consisted of Danggui Shen (Radix Angelicae Sinensis), Fuling (Poria), each 1 qian; Chao Shaoyao (Fried Radix Paeoniae Alba), Digupi (Cortex Lycii), Baizhu (Rhizoma Atractylodis Macrocephalae), Chuanxiong (Rhizoma Chuanxiong), Renshen (Radix Ginseng), each 8 fen; Huangqin (Radix Scutellariae), Lujiao Jiao (Colla Cornus Cervi), each 1 qian; Zhi Cao (Honey-fried Radix Glycyrrhizae), Shudi (Prepared Radix Rehmanniae), Cheqianzi (Semen Plantaginis), each 5 fen; and two Jujubes (Fructus Jujubae). Decocted in water and taken orally. After several doses, she recovered. Subsequent treatments on other women also proved effective.
Cheng Mingyou treated a woman suffering from persistent leukorrhea. The physician administered Jingjie Tiaojing Ji (Regulating Menses Formulas), which caused increased bleeding. Then cold-natured medicines were given, leading to diarrhea. Her muscles became emaciated, she could not speak, and her four limbs were cold. Cheng examined her pulse, which was fine as a silk thread, and said, "The Yang Qi is deficient and unable to nourish Yin. The method should be warming and tonifying. When Yang generates, Yin grows, and blood leakage will cease." He prescribed Renshen (Radix Ginseng) 2 liang and Fuzi (Radix Aconiti Lateralis Preparata) three slices, decocted strongly. After one dose, her hands and feet became slightly warm; after the second dose, she desired food. Continuing with Bazen Tang (Eight-Tonics Decoction) for forty doses led to recovery.
Lizhai (Xue Ji) treated a woman with dizziness, expectoration of phlegm, chest fullness, and panting, which relieved slightly after eating. She suffered from leukorrhea for over twenty years without response to various medicines. Xue said, "This is Qi deficiency with Phlegm-Fluid retention. Once the Fluids are resolved, the leukorrhea will heal." He used Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). Within a month, it proved effective.
Zhen noted: How can Liuwei Dihuang Wan treat Phlegm-Fluid? For this syndrome, it would be appropriate to combine Liujunzi Tang (Six-Gentlemen Decoction) with Shenqi Wan (Kidney-Qi Pill). Similarly, in the first case, Shudi (Prepared Radix Rehmanniae) was used in only 5 fen; in the second case, Fuzi (Radix Aconiti Lateralis Preparata) was only three slices. Both are difficult to understand.
A woman experienced acid regurgitation, chest fullness, poor appetite, loose stools, and irregular menstruation. After taking Qingqi Huatan Wan (Clearing Qi and Resolving Phlegm Pill), her knees gradually swelled, she experienced alternating chills and fever, yellowish-white leukorrhea, sallow complexion, and fatigue. This was Spleen-Stomach deficiency with Damp-Heat pouring downward. She was treated with Buzhong Yiqi Tang (Middle-Warming and Qi-Supporting Decoction), doubling the dosage of Renshen (Radix Ginseng) and Baizhu (Rhizoma Atractylodis Macrocephalae), adding Fuling (Poria), Banxia (Rhizoma Pinelliae Preparata), and Paojiang (Baked Ginger Rhizome), resulting in recovery. If symptoms arise from anger, causing fever, poor appetite, red and swollen legs, or dampness between fingers, use Liujunzi Tang (Six-Gentlemen Decoction) added with Chaihu (Radix Bupleuri) and Shengma (Rhizoma Cimicifugae), along with Buzhong Yiqi Tang (Middle-Warming and Qi-Supporting Decoction).
Sun Dongsu treated Lady Wu, over sixty years old, who had suffered from leukorrhea for a long time. Various treatments failed, and it progressed to Baileng (profuse white vaginal discharge). The pulse at Right Cun was slippery, Left Cun was short and weak, both Guan positions were soggy, and both Chi positions were soft and weak. Sun said, "According to the pulse, both Heart and Kidney are deficient, while there is Dampness in the Middle Jiao. Now that excessive white discharge depletes Qi and Blood daily, the method should be drying Spleen Dampness while tonifying Heart and Kidney." He formulated Jiji Dan (Ji-Ji Pill), using Lujiaoshuang (Cornu Cervi Frustum), Danggui (Radix Angelicae Sinensis), and Fuling (Poria), each 2 liang; Shichangpu (Rhizoma Acori Tatarinowii) and Yuanzhi (Radix Polygalae), each 1.5 liang; Longgu (Os Draconis) and Baishizhi (Kaolinite), each 1 liang; and Yizhiren (Semen Alpiniae Oxyphyllae), 5 qian. These were made into pills with Yam paste and taken on an empty stomach to tonify Heart and Kidney. He also formulated Duansha Wan (Stop-Discharge Pill), using Tou'er Can Sha (Silkworm excrement from the first two molts) stir-fried 3 liang, Huangjingzi (Fructus Viticis Negundo) stir-fried 2 liang, Haipiaoxiao (Endoconcha Sepiae) scraped clean, and Chu Genbaipi (Cortex Ailanthi Alabulae), each 1 liang. Made into pills with flour paste and taken in the afternoon to dry Dampness in the Middle Palace. She recovered before finishing the course.
Zhen noted: Among contemporary women, eight or nine out of ten suffer from leukorrhea, and eight or nine out of ten of these cases are deficiency syndromes. Among deficiency syndromes, those complicated by Liver Fire or Damp-Heat account for eight or nine out of ten. Cases that are purely excess (Liver Fire and Damp-Heat without deficiency) constitute only one or two out of ten. Therefore, although the collected cases in this section are few, the general principles of treatment are roughly visible.